VIDEO SPOTLIGHT: Cancer Science News features Dr. Ben Ho Park on younger women with breast cancers + environmental impact
Ben Ho Park, MD, PhD, is Director of the Vanderbilt-Ingram Cancer Center (VICC). Dr. Park is also a Professor of Medicine in the Department of Medicine's Division of Hematology and Oncology. Dr. Park's research is dedicated to finding a cure for all types of breast cancer by investigating mutated and altered genes responsible for the development and progression of breast cancer, as well as genes that lead to drug resistance. He is actively involved with the VICC Breast Cancer Research Program’s clinical research team to translate his research into clinical practice and patient care. (Complete interview & feature story) |
A report by: Dr. Noelle Cutter & Ben Honigsfeld - (Molloy University)
Breast cancer is a current health concern, affecting millions of women globally. In 2023, it was the leading cause of death due to cancer in the United States (ref). While genetic factors and lifestyle choices play significant roles in its development, emerging evidence suggests that environmental exposures also contribute to breast cancer incidence rates. Long Island, New York, has garnered attention due to its elevated breast cancer rates compared to national averages, prompting investigations into the potential environmental factors driving this phenomenon.
Whether environmental contaminants increase breast cancer risk among women on Long Island, NY, is unknown. In the early 1990s, breast cancer advocates petitioned the United States Congress to investigate the high rates of breast cancer on Long Island in the state of New York (1992-1996 117.8 per 100,000 in Nassau County, 113.6 in Suffolk county vs national average (NYS Cancer Registry, 2023). The resulting law led to the Long Island Breast Cancer Study Project (LIBCSP)--more than ten collaborative research projects designed to study the possible causes of this increased incidence of cancer. This project reported that there was no evidence that environmental exposures were responsible (ref, LIBCSP). However, the rate of BC on Long Island remains high compared to other regions in the United States (2016-2020 Nassau 145.9 and Suffolk 139.9) (NYS Cancer Registry, 2023). and has led to speculation that environmental risk factors remain an important cause of breast cancer.
Endocrine-disrupting chemicals (EDCs) are natural or human-made chemicals that may mimic, block, or interfere with the body’s hormones, which are part of the endocrine system. These chemicals are associated with a wide array of health issues, including cancers (Safe, 2000). Endocrine disruptors are found in many everyday products, including some cosmetics, food and beverage packaging, toys, carpet, and pesticides. Some chemicals that act as flame retardants may also be endocrine disruptors. Long Island’s environment is full of potential sources of EDCs, which have been linked to an increase in breast cancer development.
A study by Soto et al. (2015) highlighted the presence of EDCs such as bisphenol A (BPA) and phthalates in everyday consumer products, including plastics and personal care items. These chemicals can interfere with hormonal signaling pathways, such as the estrogen, androgen, and growth factor signaling pathways. EDCs such as BPA, phthalates, and certain pesticides can mimic estrogen's action by binding to estrogen receptors (ERs) and activating estrogen-responsive genes and turning on downstream transcription factors which are involved in pathways associated with many cancers, including breast cancer. The Androgen Signaling Pathway can also be impacted by EPCs. Androgens, such as testosterone, play crucial roles in the development and maintenance of male reproductive tissues and secondary sexual characteristics. EDCs can disrupt androgen signaling by interfering with androgen receptor (AR) activation or inhibiting androgen synthesis. This disruption can impact reproductive health, development, and hormone-sensitive tissues in both males and females (Akdag et al., 2016).
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FOR IMMEDIATE RELEASE: National Dense Breast Disclosure Law, taking effect on 9/10/2024
6/18/2024 - Hartford, CT. The Are You Dense Foundation is proud to confirm the National Dense Breast Disclosure Law on September 10, 2024 at the Connecticut Legislative Office Building. This
groundbreaking law aims to empower women by ensuring they receive
crucial information about their breast density during mammography
screenings.
Connecticut is taking the lead in championing breast density awareness, recognizing the importance of transparency and informed decision-making for women's well-being. The National Dense Breast Disclosure Law requires healthcare providers to inform patients about their breast density during mammography screenings. By providing this vital information, women can better understand their individual risk factors and seek appropriate medical care. Together, we will celebrate this historic moment and the power of knowledge in women's healthcare decisions.
This event marks a significant milestone in women's health. According to co-founder and executive director Joe Cappello, "this law is a bold step in implementing this law is expected to set a national precedent... in September, this law will become effective nationwide, ensuring that women across the country have access to this essential information. This law showcases Connecticut's commitment to women's health and its determination to make a positive impact on a national scale. By raising awareness about breast density and empowering women with knowledge, lives can be saved and the overall well-being of women can be improved."
This event is welcome to the public to attend. September 10, 2024 (11am - 1pm) at the at the Connecticut Legislative Office Building 300 Capitol Ave #5100, 2nd Floor, Hartford, CT. There will be guest speakers and a light lunch. For more information, visit: www.AreYouDense.org and www.AreYouDenseAdvocacy.org
REMEMBERING NANCY
6/15/2024- In celebration of the upcoming birthday of the late Dr. Nancy Cappello (Oct. 30), the ICRS (Integrative Cancer resource Society) gives honor to her courage and life-saving pursuits to bring global awareness about the risks of Breast Cancer from the link to dense breast tissue. Dr. Cappello’s work to inform women about the risks of dense breast tissue led to density inform laws in 35 states. Her advocacy also led to bringing clinical reform to earlier detection screening. According to Dr. Roberta Kline (Women's Health Digest medical publisher) and Dr. Leslie Valle- Montoya (ICRS exec. director), "...though we all know her passing to earmark a major movement in women's health, honoring the birthdate of such a figure posthumously (we feel) better resonates a more loving and eternal remembrance of message by breathing continued life to her legacy!" (See original source: ITN NEWS)
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Experimental semivariogram of observed rates before (top curve) and after weighting by the population size, with the model fitted. Scatterplots illustrate the impact of filtering on variability among rates, as a function of the female population size. SOURCE: ResearchgateAdditionally, the Growth Hormone/Insulin-like Growth Factor (GH/IGF) Signaling Pathways are critical regulators of growth, development, and metabolism. EDCs like polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzofurans (PCDFs) can interfere with GH/IGF signaling pathways, affecting cellular proliferation, differentiation, and apoptosis. Disruption of these pathways by EDCs may contribute to altered growth patterns and increased susceptibility to cancer and potentially increasing breast cancer risk. Moreover, Long Island's proximity to industrial sites and agricultural areas raises concerns about exposure to these environmental EDCs with studies suggesting a possible association between pesticide exposure and breast cancer incidence (Engel et al., 2017). Contact with these chemicals may occur through air, diet, skin, and water.
AIR & WATER POLLUTION:Long Island's densely populated urban areas are susceptible to high levels of air pollution, including particulate matter and volatile organic compounds (VOCs), which have been implicated in breast cancer development (Hystad et al., 2013). Additionally, concerns have been raised about groundwater contamination from industrial activities and pesticide runoff from agricultural lands. A case control study investigating pesticide use on Long Island identified that women using higher amounts of pesticide in and around their homes had a greater than 30% increase in risk of developing breast cancer. In addition, use of most individual and combined lawn and garden pesticides examined by the study identified a consistent elevation in breast cancer risk (Teitelbaum et al., 2007).
However, the lack of dose-response relationship and conflict of the LIBCSP study results indicates the need for additional research. In addition to pesticides, a major source of contamination is due to the Navy-Grumman groundwater plume. Beginning operation in the 1930s, the 600 acre Northrop Grumman-Bethpage Facility and Naval Weapons Industrial Reserve plant site was utilized for military industry and research until 1996 (DOJ, 2022). During this time, Northrop Grumman’s activities lead to the contamination of the soil and groundwater with volatile organic compounds, polychlorinated biphenyls, metals, and many others (NYSDOH, 2022). These contaminants were first detected in the 1970s, allowing for decades of unopposed groundwater, soil and air contamination.
Furthermore, the New York Department of Health estimates that groundwater contamination reaches up to 750 feet deep, and stretches over 3800 acres (NYSDOH, 2022). This dumping took place on land now surrounded by residential neighborhoods, thus posing a major hazard to the community. As of March 2024, buried contaminants are still being discovered, with additional potential sources still expected to be present (DEC, 2024).
There was also detection of similar contaminants at the Naval Weapons Industrial Reserve Plant in Calverton in eastern Long Island, which resulted in closure of all wells on the contaminated property in 2012 (NYSDOH, 2022). Amongst the contaminants identified as part of the Northrop-Grumman plume, concerns have been raised regarding 1,4 dioxane in particular, a solvent stabilizer rated by the EPA as a likely human carcinogen. In an evaluation of 4,400 water sources across the country, the EPA identified Long Island as having among the highest levels of 1,4 dioxane (EPA, 2021). In response, the Yale Superfund Research Center has initiated a series of 4 projects to measure the exposure to 1,4 dioxane and connection to adverse biological effects (Kim & Fortner, N.D.).
In addition to spillage from Northrop-Grumman, the Hooker Chemical & Plastics Corp./Ruco Polymer Corp plant formerly located in Hicksville was discovered to have contaminated the groundwater with vinyl chloride, trichloroethylene, barium, cadmium, organic acids, and other compounds due to dumping practices. These activities were discovered in 1984 after several decades of operation, and groundwater cleanup is still underway (EPA, N.D.). Unfortunately, It is clear that Long Island has suffered decades of hazardous waste exposure through soil, water, and air.
A study by Gammon et al. (2002) found an association between residential proximity to hazardous waste sites and increased breast cancer risk among Long Island women, highlighting the potential role of environmental pollutants in driving breast cancer incidence rates. Besides cancer, environmental pollution has also been linked to increased rates of cardiovascular, reproductive, neurological, gastrointestinal, respiratory, and developmental disorders among other complications (Shetty et al. 2023).
RADIATION EXPOSURE:Long Island's history of nuclear facilities and radioactive waste sites raises concerns about radiation exposure and its impact on breast cancer risk. Namely, the Shoreham Nuclear Power Plant, decommissioned in 1994 before becoming fully operational due to public safety concerns. During the breakdown process, 5 million pounds of radioactive waste via 353 truckloads, as well as water barges to remove 560 irradiated fuel assemblies was required (NYT, 1994). In Upton, Suffolk County, Brookhaven National Laboratory experienced a tritium leak in 1998, leading to tritium in the groundwater above the state and federal drinking levels (Brookhaven Bulletin, 1998). This culminated in a shutdown of the High Flux Beam Reactor (ANS, 2022). The extent and harm of the leak remains a point of controversy, and has been designated as a superfund site by the EPA and is under periodic 5-year review (EPA, 2024).
Irradiated surfaces were treated and the area remains at normal background levels according to state officials . While medical imaging and radiation therapy contribute to some extent, historical exposure to ionizing radiation from nuclear facilities may have long-term health consequences. A study by Boice et al. (2012) suggested an increased risk of breast cancer among individuals exposed to low-dose ionizing radiation, emphasizing the importance of monitoring and mitigating radiation hazards in the environment. The effects of ionizing radiation on the destabilization of DNA have been well documented, with research particularly emphasizing double strand breakage, and generation of reactive oxygen and nitrogen species (Helm & Rudel, 2020).
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Furthermore, ionizing radiation has been found to cause epigenetic alterations, including alterations in DNA methylation and histone acetylation (Pogribny, 2019). with regards to breast cancer specifically, no association was found with high levels of UV radiation and overall breast cancer incidence (Gregoire et al., 2022) However, ionizing radiation has been demonstrated to increase the incidence of breast cancer in women in a dose-dependent manner, especially when the exposure occurs at a young age (Helm & Rudel, 2020).
Addressing the environmental impact on breast cancer incidence requires a collaborative effort involving community engagement, advocacy, and policy interventions. Clearly, more research is needed to ascertain the environmental impact on the increased incidence of breast cancer on Long Island. By leveraging scientific research, community engagement, and policy advocacy, Long Island can work towards reducing breast cancer incidence rates and improving the overall health and well-being of its residents.
References: https://prevention101.org/refs_6-13-2024-N.Cutter.html
CONTRIBUTORS
DR. NOELLE CUTTER is a professor of biology, ironman finisher, and advocate for dense breast screening. United with an expanding research team dedicated to collecting data on women with dense breasts and screening options for these patients, her initiative aims to investigate and gather conclusive information about dense breasts in specific groups- including age, body mass index, and amount of physical activity and the underlying diagnostics of breast cancer tumors. This research program is under a partnership with Molloy College and Dr. Robert Bard, expert diagnostic cancer imaging specialist in NYC and other colleagues from the NY Cancer Resource Alliance.
If you like our feature story on Long Island Breast Cancer, you may also want to check out our other cancer science news features:  |
The Women's Health Digest and HealthTech Reporter proudly introduces the latest installation of the Prenuvo clinic in New York City thanks to the test-drive of our own editor: Dr. Roberta Kline. All Prenuvo facilities offer the most current diagnostic advancement in whole body MRI imaging. Recognized for its volume of diagnostic-quality images acquired under one hour, Prenuvo's capacity to capture whole-body imaging through its unique, cutting edge analytic software offers a comprehensive array of next generation applications for early detection and real-time monitoring of complex diseases and cancers. Check out her front-row tour of the PREVUVO EXPERIENCE. |
ON GENETIC TESTING & HEREDITY
Originally published in Health Resource Digest (5/1/2024)
Samantha Hunt, 24 is a young cancer awareness advocate due mostly to the upbringing of two cancer survivors who are outspoken about environmental cancers and proactive testing ("Get Checked NOW!" program). She is in a graduate program for social work and grew up in a household in support of prevention and early detection. Since she was 9 years old, Samantha took on personal studies on breast cancer when she watched her mother (Jennifer) undergo a bilateral mastectomy for early-stage breast cancer. Samantha's father was diagnosed with early-stage prostate cancer, and her maternal aunt also had breast cancer. By her late teens into her college years, Samantha was convinced that she needed to have early screening, which is when she discovered she had dense breast tissue- a condition that is present in over half of women in the U.S.
(see complete story)
NEWS: FROM THE LAB
CHANGES IN BREAST CANCER CARE IN NEW YORK DURING THE COVID-19 PANDEMIC By: Alexandra Fiederlein | Cheyenne Rosado | Noelle Cutter
Breast cancer is the second most common malignancy among women in the United States. As such, the COVID-19 pandemic has caused medical facilities to change their methods of operation since March of 2020, including changes in diagnosis and treatment plans. New York (NY) has an unusually high incidence of breast cancer. This study analyzed the effects of the COVID-19 pandemic on breast cancer care (BCC) in NY. Women in NY that were diagnosed with or in remission for breast cancer were asked to take an online, anonymous survey regarding their BCC experience. For patients in treatment, 26% of women wished they had greater emotional support or had a family member included in their appointments. 39% of women do not feel they are receiving as good of care as before, while 31% feel they are receiving the same level of care. Additionally, 41% of women feel they received the same level of care over telemedicine.
Our data show a negative correlation between the quality of care received during the pandemic and the wish for more emotional support and inclusion of supportive members in the care process (nonsignificant). There was less of a negative correlation between the quality of telemedicine care received during the pandemic and the wish for more emotional support and inclusion of supportive members in the care process (nonsignificant). This indicates that most women lacking emotional support reported worse BCC experiences, and telemedicine use was not as troublesome to patients as the lack of emotional support. Most women in treatment and in remission reported negative feelings like fear when asked about their BCC experiences. Our data show the importance of emotional support for breast cancer patients and those in remission during the COVID-19 pandemic. Our work could also provide clinicians with the knowledge necessary on how breast cancer care should be handled in an evolving pandemic such as COVID-19.
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I sit on the advisory board for cancer at Mount Sinai Hospital and I'm a special assistant to the Commissioner of Health of Nassau County. I work for the health department. I also sit on the Medical Society board for Nassau County. My outreach goes everywhere - it doesn't stop at the front door of Hewlett house.
